ASC X12 276/277 Claims Status Request/Response Transaction

20 - ASC X12 276/277 Claims Status Request/Response Transaction Standard (Rev. 10236, Issued: 07-31-2020, Effective: 08-31-2020, Implementation: 08-31-2020) These instructions apply to Medicare Administrative Contractors (MACs), Durable Medical Equipment Medicare Administrative Contractors (DME MACs), the Common Electronic Data Interchange (CEDI) contractor for DME MACs, and their shared systems on Medicare requirements for their implementation of the current HIPAA compliant version of the ASC X12 Health Care Claim Status Request and Response (276/277) transaction (short reference: ASC X12 276/277 claim status request and response.) CMS supports the current version of this transaction as established in its TR3 adopted under HIPAA: the ASC X12 Standards for Electronic Data Interchange Technical Report Type 3—Health Care Claim Status Request and Response (276/277). In order to implement the HIPAA administrative simplification provisions, the ASC X12 276/277 claim status request and response and its implementation specification (now TR3) have been named under part 162 of title 45 of the Code of Federal Regulations as the electronic data interchange (EDI) standard for Health Care Claim Status Request/Response. All other EDI formats for health care claims status request and response became obsolete October 16, 2003. The Final Rule for Health Insurance Reform: Modifications to the Health Insurance Portability and Accountability Act (HIPAA) Electronic Transaction Standards published in the Federal Register on January 16th, 2009, adopts updated versions of the electronic transactions and TR3 for the ASC X12 276/277 claim status request and response. Furthermore, the Final Rule conveys inclusion of errata to the transaction standard. CMS therefore incorporates by reference any errata documents by the original mandated regulation compliance date through the Federal Register notice(s). Moving forward, all newly adopted errata documents are to be accepted and integrated as part of the EDI transaction. The ASC X12 TR3 for the ASC X12 276/277 claim status request and response standard may be found at the official ASC X12 website. The ASC X12 276/277 is a “paired” transaction (the ASC X12 276 is an in-bound claim status request, and the 277 is an outbound claims status response).